Why is high blood pressure associated with anger?

Anxiety as an important factor

When it comes to the secondary causes of hypertension, one important factor remains unmentioned: fear. Anxiety disorders often manifest themselves physically - even without manifest anxiety - in the form of tachycardia, shortness of breath, heartache, dizziness, multilocal pain, elevated temperature and arterial hypertension (1). In somatized anxiety attacks, values ​​of systolic 300 and diastolic 120 mmHg can be achieved.

This can be explained as follows: The latent feeling of fear brings the vegetative part, the muscle tone (pain) and the thyroid gland (hyperthyroidism) into full swing. With every resistant high blood pressure, fear should therefore be considered, especially if further fear equivalents such as waking up at night with sweating and cravings are determined. With the "white coat hypertension" the authors even associate high blood pressure with fear.

In these patients, the blood pressure values ​​usually drop significantly when it is possible to talk about their - previously unconscious - fear and their biographical background. Anger or sadness can also be associated with fear. What is decisive is naming ("Your high pressure is fear ... is anger ...") and understanding the affect.

Only when the affective dimension of hypertension has been taken into account diagnostically and therapeutically and the receptive methods have been exhausted should the invasive method of renal denervation be considered.

DOI: 10.3238 / arztebl.2012.0311b

Dr. med. Mechthilde Kütemeyer

Fichtenstrasse 52, 68535 Neckarhausen, [email protected]

Conflict of interest

The author declares that there is no conflict of interest.

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